Problems of Forensic Sciences 2011 Vol. 85 (LXXXV) 64-74
EVALUATION OF THE DIAGNOSTIC USEFULNESS OF AMANITIN DETERMINATION BY ENZYME-LINK IMMUNOSORBENT ASSAY (ELISA)
Ewa GOMÓŁKA1, 2, Dorota SZPAK1, Agnieszka MORAWSKA1
1Department of Toxicology and Environmental Disease, Collegium Medicum, Jagiellonian University, Kraków, Poland
2Laboratory of Toxicology, Ludwik Rydygier Specialist Hospital, Kraków, Poland
Streszczenie
Accidental consumption of poisonous species of wild mushrooms may have tragic consequences. Rapid and reliable differential diagnosis in cases of accidental consumption enables ascertainment of whether Amanita phalloides poisoning has occurred and hence early implementation of treatment, before liver and kidney failure occur. The aim of the study was to show the usefulness of amanitin determination in the diagnosis and treatment of patients with suspected poisoning by these mushrooms. The medical histories of patients with suspected poisoning treated at the Toxicology Clinic, Collegium Medicum, Jagiellonian University in Krakow (KT CM UJ) in the years 2007–2009 were analysed. Amanitins in urine were determined by the ELISA method, making use of reagents produced by Bühlmann. Amanitin determination was performed on 55 patients, of whom 28 were admitted to KT CM UJ. In 14 cases, phalloides syndrome was diagnosed. In this group, the result of amanitin determination was positive in 11 patients (>5 ng/ml). A negative (<1.5 ng/ml) and doubtful result (1.5–5 ng/ml) was ascertained in patients with a diagnosis of gastritis, gallstones (cholelithiasis), and also after consumption of Amanita, when urine was collected for analysis longer than 48 hours after consumption of mushrooms. Determination of amanitin in urine allowed us to distinguish phalloides syndrome from nonspecific gastroenteritis. Quick commencement of treatment contributed to a better prognosis for poisoned patients.
Słowa kluczowe
Mushroom poisoning; Phalloides syndrome; Amanitin; ELISA.